Two or more prescription or over-the-counter drugs may interact negatively with each other and cause adverse drug reactions. To reduce the risk of drug reactions, one must adopt the following guidelines:

Read labels carefully.

Understand the ingredients in each drug.

Understand any possible side effects they can cause.

Before taking a drug speak with the doctor or pharmacist if you don't understand the drug label.

Make sure the doctor is aware of all the drugs you are taking.

Don't mix pills.

Don’t break capsules into any food or drink.

Don't take any medication with alcohol.

Don't take medication at the same time as vitamins or mineral supplements.

Heart Care Foundation of India and World Fellowship of Religions in association with Ministry of Earth Sciences Govt. of India and Delhi Public School Mathura Road observed World Earth Day 2013.

National News

300,000 newborn deaths each year in India: report

New Delhi: More than 300,000 babies die within 24 hours of being born in India each year from infections and other preventable causes, a report said Tuesday, blaming a lack of political will and funding for the crisis. India accounts for 29% of all newborn deaths worldwide, according to the charity Save the Children which published the findings at the launch of its annual State of the World's Mothers report.

The report on 186 countries showed South Asia -- which accounts for 24% of the world's population -- recording 40% of the world's first-day deaths. Bangladesh and Pakistan also have large numbers of yearly first-day deaths at 28,000 and 60,000 with chronic malnourishment of mothers one of the major factors for the fatalities in the region. "Progress has been made, but more than 1,000 babies die every day on their first day of life from preventable causes throughout India, Pakistan and Bangladesh," said Mike Novell, the regional director of the charity.

The charity identified three major causes of newborn deaths -- complications during birth, prematurity and infections -- and said access to low-cost, life-saving interventions could cut down the figures by as much as 75%. "What is lacking is the political will and funding to deliver these solutions to all the mothers and babies who need them," it said.

A decade of rapid economic growth has allowed India to boost spending on poor and rural communities but Save the Children said most such programmes had not benefited those most in need. More than half of all Indian women give birth without the help of skilled health care professionals, leading to infections and complications. In far-flung areas, doctors and hospitals are rare and villagers often put the health of their children in the hands of poorly trained substitutes. But even in cities such as New Delhi with relatively better healthcare facilities women are delivering at home, said Sharmila Lal, a Delhi-based gynaecologist.

"Even if hospitals are near at hand, the women are having babies at home in a highly unsafe and unhygienic environment just because of lack of awareness," Lal added. Lal said India must invest in creating a pool of paramedical staff trained in childbirth to take the load off doctors "who often don't have time or patience to explain simple life-saving measures to expectant mothers". The charity said the problem of infant mortality could be addressed by closing the equity gap in a developing country like India where economic benefits have been shared unequally. "If all newborns in India experienced the same survival rates as newborns from the richest Indian families, nearly 360,000 more babies would survive each year," the report said. (Source: Hindustan Times, May 07, 2013)

Adults with amblyopia who played a video game binocularly and under conditions that reduced the visual stimulus to their better-seeing eye showed gains in stereopsis and in visual acuity (VA, logMAR units) in the amblyopic eye. The researchers saw much smaller improvements in participants who played the game monocularly. (Source: Medscape)

Ambrisentan fails in lung fibrosis

The ARTEMIS-IPF clinical trial showed that the pulmonary hypertension drug ambrisentan (Letairis), which was supposed to tackle one of the root causes of idiopathic pulmonary fibrosis actually worsened that disease. (Source: Medpage Today)

Malignancy less likely in incidentally discovered thyroid nodules

Thyroid nodules found on clinical examination were much more likely to be malignant than were those seen incidentally during imaging studies for other reasons, according to a new review of 200 consecutive patients referred to a thyroid center (at the American Association of Clinical Endocrinologists (AACE) 22nd Annual Scientific and Clinical Congress). (Source: Medscape)

Religion powers end-of-life care

Terminal cancer patients with strong religious support were more likely to receive invasive treatments when near death than those without such connections, researchers said. (Source: Medpage Today)

New sex 'superbug' may be more infectious than AIDS

Washington: Doctors are warning of a new sexually-transmitted superbug which they fear could ultimately prove to be even more deadly than AIDS. The antibiotic-resistant strain of gonorrhoea - now considered a superbug - was discovered in Japan two years ago. Experts have warned that the bacteria's effects could match those of AIDS. (Source: TOI, May 7, 2013)

Anonymous donors: Women who are not known to the recipient. Donors maybe recruited through established egg donation programs, or may be identified through agencies.

Known or directed donors: Women who are known to the recipient. The donor is generally a close relative or friend. In some instances, recipients advertise directly for donors in newspapers or on the Internet. In these circumstances, the recipient couple and the donor are known to each in a limited way, having met without an intermediary program or agency.

IVF programs: Women undergoing IVF may agree to donate their excess egg to infertile patients. This source of donors is limited, probably because of the perceived coercive nature of the donation if the women are offered a financial discount on their own IVF cycle.

Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Patient care during and after transfusion

The transfusionist should remain with the patient for the first few minutes of the transfusion, which should be started slowly.

Catastrophic reactions from acute hemolysis, anaphylaxis, or bacterial contamination can become apparent after a very small volume enters the patient’s circulation.

After first 15 minutes, the patient should be observed and the vital signs recorded; if the patient’s condition is satisfactory, the rate of infusion can be increased as desired.

Clinical personnel should continue to observe the patient periodically throughout the transfusion and up to an hour after completion.

One morning I wasted nearly an hour watching a tiny ant carry a huge feather across my back terrace. Several times it was confronted by obstacles in its path and after a momentary pause it would make the necessary detour. At one point the ant had to negotiate a crack in the concrete about 10mm wide. After brief contemplation the ant laid the feather over the crack, walked across it and picked up the feather on the other side then continued on its way.

I was fascinated by the ingenuity of this ant, one of God’s smallest creatures. It served to reinforce the miracle of creation. Here was a minute insect, lacking in size yet equipped with a brain to reason, explore, discover and overcome. But this ant, like the two-legged co-residents of this planet, also shares human failings. After some time the ant finally reached its destination – a flower bed at the end of the terrace and a small hole that was the entrance to its underground home. And it was here that the ant finally met its match. How could that large feather possibly fit down that small hole? Of course it couldn’t. So the ant, after all this trouble and exercising great ingenuity, overcoming problems all along the way, just abandoned the feather and went home.

The ant had not thought the problem through before it began its epic journey and in the end the feather was nothing more than a burden. Isn’t life like that! We worry about our family, we worry about money or the lack of it, we worry about work, about where we live, about all sorts of things. These are all burdens – the things we pick up along life’s path and lug them around the obstacles and over the crevasses that life will bring, only to find that at the destination they are useless and we can’t take them with us.

After shopping for most of the day, a couple returns to find their car has been stolen. They go to the police station to make a full report. Then, a detective drives them back to the parking lot to see if any evidence can be found at the scene of the crime. To their amazement, the car has been returned.

There is an envelope on the windshield with a note of apology and two tickets to a music concert. The note reads, 'I apologize for taking your car, but my wife was having a baby and I had to hot-wire your ignition to rush her to the hospital. Please forgive the inconvenience. Here are two tickets for tonight's concert of Garth Brooks, the country-and-western music star.'

Their faith in humanity restored, the couple attend the concert and return home late. They find their house has been robbed. Valuable goods have been taken from though out the house, from basement to attic. And, there is a note on the door reading, 'Well, you still have your car. I have to put my newly born kid through college somehow, don't I?'

What is the August 5, 2005 Supreme Court judgment on medical negligence?

Cases of doctors being subjected to criminal prosecution are on an increase. Sometimes such prosecutions are filed by private complainants and sometimes by police on an FIR being lodged and cognizance taken.

The investigating officer and the private complainant cannot always be supposed to have knowledge of medical science so as to determine whether the act of the accused medical professional amounts to rash or negligent act within the domain of criminal law under Section 304–A of IPC.

The criminal process once initiated subjects the medical professional to serious embarrassment and sometimes harassment.

He has to seek bail to escape arrest, which may or may not be granted to him.

At the end he may be exonerated by acquittal or discharge but the loss which he has suffered in his reputation cannot be compensated by any standards.

We may not be understood as holding that doctors can never be prosecuted for an offence of which rashness or negligence is an essential ingredient.

All that we are doing is emphasizing the need for care and caution in the interest of society; for, the service which the medical profession renders to human beings is probably the noblest of all, and hence there is a need for protecting doctors from frivolous or unjust prosecutions.

Many a complainant prefer recourse to criminal process as a tool for pressurizing the medical professional for extracting uncalled for or unjust compensation. Such malicious proceedings have to be guarded against.

One loose motion is equal to one glass of ORS. Most summer diarrhea is watery, effortless and painless diarrhea with no mucous or blood. They need no antibiotics. The only treatment is oral rehydration solution, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President-Elect IMA.

One loose motion is equivalent to loss of one glass of fluid. Explaining this, Dr. Aggarwal said that if a patient has passed 10 loose motions, he needs 12 glasses of ORS apart from normal requirement of fluids and one glass for every loose motion passed again. For up to 12 loose motions, a patient can be managed as an out patient but if the loose motions are more than 12, he needs observation and if the numbers of loose motions are more than 40, he needs intensive treatment.

The main complication is renal shut down, which will happen if the blood pressure remains low for more than few hours. During loose motions one should maintain that he or she passes urine every 6-8 hours. If no urine is passed for eight hours it may indicate an impending renal failure.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 47982 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10x10 i.e. 100 per minute.”